Effects of the home environment on respiratory symptoms of a general population sample in middle Italy.

The effects of home environment characteristics were evaluated in a multistage, stratified, cluster sample (N = 3,866) of the general population who lived in the district of Pisa (middle Italy). Each subject completed a standardized interviewer-administered questionnaire that contained questions about respiratory symptoms/diseases and risk factors (e.g., type of heating, fuels used for cooking and heating). Cough and asthma were significantly more frequent in men who did not smoke and who did not use natural gas for cooking and heating. Attacks of shortness of breath accompanied by wheeze, dyspnea, and cardiovascular conditions in female nonsmokers were associated with use of a stove or forced-air circulation for heating; the type of fuel used did not affect this result. Multiple logistic models, which accounted for independent effects of age, smoking status, pack-years, childhood respiratory illness, education, zone of residence, and work exposure to dusts, chemicals, or fumes, showed significantly increased odds ratios for (a) cough and phlegm in males (associated with bottled gas for cooking), (b) wheeze and shortness of breath with wheeze in females (associated with the use of a stove or forced-air circulation). These results, which confirm our previous observations in an unpolluted rural area of north Italy, indicate that characteristics of the home environment, as assessed by questionnaire, may be linked to mild adverse health effects, i.e., respiratory symptoms, in the general population. The results also identify the need to better characterize the dose-response relationship in indoor air pollution monitoring studies that include subsamples of this population.